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Neurofeedback News

Monthly summary of general news, case histories,
and introductory articles about neurofeedback
for the interested layperson

Vol. 4 No. 2 - February 15, 2001

Past issues are available at www.eegspectrum.com/news/
Copyright (C) 2001 by EEG Spectrum International. All rights reserved.



  • Announcements  - Magazine articles
  • Focus - When is Theta Alpha?
  • News & Reviews - Recent books and articles

  • Announcements

    Focus

    When is Theta Alpha?
    The world is becoming more customized every day, yet many of us continue to use off-the-shelf principles when we assess or train individuals. In his first report Hans Berger (1929) characterized the "waves of the first order" in human EEG -- which for the sake of brevity he designated alpha. The "alpha rhythm" had large sinusoidal waveforms at a rate around 10 cycles per second against a background of smaller waves, "waves of the second order" (i.e., beta). Alpha waves were pronounced in posterior regions during eyes closed resting states, and diminished markedly upon opening the eyes.

    This is how the alpha rhythm was defined 70 years ago. Today we have a superior definition: Alpha activity occurs between 8 and 13 Hz, or is it between 8 and 12 Hz, or perhaps 7 and 13 Hz, or 7.81 and 14.06 Hz, or 8 and 15 Hz (Etevenon et al, 1990, Ray & Cole, 1985); you get the picture. What is more disturbing than the different intervals are their boundaries, which are artificial, a product of ease of communication and the limits of one's analytical technique. The alpha rhythm is defined as the dominant frequency rhythm in the resting state, the frequency band that dominates the spectral density distribution. At this scale the brain rarely uses integers. Perhaps we would do better to keep the names simple but not its designation.

    Klimesh (1999) developed a simple designation strategy; he identifies an individual alpha frequency (IAF) from each subject, then defines bands relative to this peak. Lower alpha is from 2.5 Hz below IAF up to IAF, and higher alpha runs from IAF to IAF plus 2.5 Hz. The theta band is also defined relative to IAF. Obviously the plus or minus 2.5 Hz is artificial and is one of those compromises plentiful to psychophysiology, based on empirical data and ease. Some subjects will have a narrow dominant frequency, others might hit the mark exactly. Perhaps a refinement of the formula is needed, a mixture of percent attenuation and topography. This might produce a truly customized dominant frequency bandwidth. From there we build towards the other bandwidths of interest. Eventually we may find out that restricting our analysis to such unique ranges can improve the reliability and validity of our conclusions.

    Above is a statistical distribution of the dominant frequency for 124 subjects. The peak frequency in five posterior sites (P3, Pz, P4, O1, & O2) during eyes closed resting baselines were calculated. Each subject provided up to seven replications (though no more than four per day). As can be seen above, the dominant frequency spreads across the 7-15 Hz range, though a bin of 8-12 Hz captures 95% of the data. Still, important individual information is lost in this depiction. For instance, to what extent does the alpha rhythm varies across this sample in both peak and shape? A review of the subjects finds a factor of two in alpha width: some subjects exhibit 40% of all alpha magnitude in a single 1-Hz (peak) frequency band whereas others never exhibit more than 20% in 1 single Hz band inside the dominant frequency range (see below).

    The large variance in peak and width begs the question: why do we use a large band to assess dominant frequency activity? Would it not be simple to calculate an IAF, even with a one-channel EEG system? The figures above are from a NORMAL ADULT population in the ALPHA RHYTHM. These three properties align to produce the most regular and consistent recording possible in human EEG. We are all aware of frontal slowing in ADHD children. Some argue convincingly that high theta activity in such a population is actually misnamed; it is merely an immature manifestation of the alpha rhythm (the child's dominant frequency). So 4-7 Hz may be theta for some and alpha for others.

    Here are two subjects who were excluded from the 124 sample for obvious reasons. Both show a lower peak frequency. One is a 3 year old child and the other at 65 entering second childhood, at least electrophysiologically. And these outliers are likely normal in this band -- at least for their group.

    Obviously we should reevaluate how we define frequency bands for clinical and scientific investigations. Especially if we are evaluating and training clinical non-adult populations. And by non-adult, we may mean anyone under 30 and over 50, according to Neidermeyer's model (1993). Cerebral maturity, I guess, is a difficult state to achieve and to maintain (see figure).

    Two months ago I was faced with a challenge. A 3 year old was about to start neurofeedback training. Given his young age and condition his EEG rhythms were immature, but the question was how immature: where was his SMR band located, for instance? The literature suggested a dominant frequency around 5 to 6 Hz, possibly higher in some toddlers. If the SMR was adjacent to the dominant frequency, as it is in normal adults, it would fall in line with some Russian research which indicated an SMR rhythm of 6fromof the child, I had little data to go on. One strategy often used in this field is to start training at the adult range (here, for SMR, 12-15 Hz) and adjust (lower) the band if the client's response is not what one expects. General knowledge in lieu of an assessment was better than nothing, so this strategy was used.

    Well, it was one of those experiences that can make or break a parent's confidence. The very first session changed everything about the child. Unfortunately it made everything significantly worse. He was trained at 12-15 Hz, site C4. Too high. After a year of holding his urine while he slept, that week he started urinating in his sleep, he became aggressive at his Special Ed school, so much so that they threatened to kick him out. The training somehow disinhibited him along both physiological (urination) and behavioral (impulse control & aggressive) domains. Needless to say, the parents of this child were not happy.

    Time to adjust the training band. And rapidly. But there was no way to gauge the results readily enough, given the child's problems. It was like trying to listen to a volume change of a jet engine during takeoff: was that 145 decibels or is he improving and now putting out only 143 dBs?

    Fortunately we were able to finally record a Q on the child. And as it happened he fell asleep in the chair -- and his EEG was soon populated with sleep spindles. Sleep spindles are produced by the same reduction of motoric input as SMR, by similar neuronal pathways, so right there, bingo! I had an easily quantified measure of the toddler's SMR rhythm. Here was the appropriate band to start training on.

    Above is 5 seconds of raw EEG data during the initial stages of sleep.

    As the spectral analysis shows, his SMR rhythm is 10-12 Hz. Perhaps a sleep recording for all clients undergoing SMR training might be helpful. It could even be achieved with a one-channel system. Place the client in a dark room, a comfy chair, and with an electrode at Cz or Fz. Wait for spindles and simply count the cycles. It's not even a Q in this EEG assessment.

    Statistical descriptions may be powerful and accurate tools, but rarely as powerful as individual data. - David Kaiser, Ph.D.


     

    News & Reviews

    NEW BOOKS



    An Odd Kind of Fame: Stories of Phineas Gage
    by Malcolm Macmillan
    Details about the famed case of railway construction worker Phineas Gage who suffered an accident that led the investigation into functional localization and the brain's role in personality.

    American Psychiatry After World War II
    by Roy W. Menninger, John C. Nemiah
    How we got to our present state of psychiatry, in 25 chapters.

    Drinking Occasions: Comparative Perspectives on Alcohol and Culture
    by Dwight B. Heath
    America's long history of ambivalence toward alcohol and mood-altering drugs is described.

    Managing the Gift: Alternative Approaches for ADD
    by Dr. Kevin Ross Emery
    An approach to managing ADD from the insights of a private practitioner.

    Learn to Sleep Well
    by Christopher Idzikowski, Chris Idzikowski
    Self-help book provides suggestions and practical exercises on how to deal with snoring partners, restless children, and nightmares, and other sources of sleep problems.

    Learning Disabilities: Theories, Diagnosis, and Teaching Strategies
    by Janet W. Lerner
    Comprehensive book of treatment approaches, evaluations, and teaching methods, strategies, and materials.

    Strong Feelings: Emotion, Addiction, and Human Behavior
    by Jon Elster
    Discusses the interrelation of three explanatory approaches to behavior: neurobiology, culture, and choice.

    A Dad's Nuts and Bolts Guide to Understanding ADD
    by Mark M. Jacob
    Honest portrayal of the difficulties with raising a child with ADD.

    A Guided Tour of Hell: In the Words of Migraine Sufferers
    by Kristine Hatak
    Depiction of migraine from a sufferer. An inside perspective.

    Addiction : Opposing Viewpoints
    by Jennifer A. Hurley
    Explores the subject of addiction through essays and opinions on two opposing theories about the root of addiction and consequent treatment: biological versus behavioral

    Integrative Neuroscience: Bringing Together Biological, Psychological and Clinical Models of the Human Brain
    by Gordon Evian
    Technical survey of brain sciences: from anatomy to psychology

    Toward Consilience: The Bioneurological Basis of Behavior, Thoughts, Experience, and Language
    by Gerald A. Cory Jr
    Attempt to follow the work of Edward O. Wilson in establishing a framework for consilience -- the unification of the natural and social sciences -- to understand how the brain shapes our behavior.

    Chronic Fatigue Syndrome, Fibromyalgia, and Other Invisible Illnesses
    by Katrina Berne, Daniel L. Peterson
    Latest findings on chronic fatigue, fibromyalgia, and related diseases such as Gulf War Syndrome.

    ARTICLES

    Traumatic stress in the 21st century. : Posttraumatic stress disorder has emerged as the most common anxiety disorder in women. Those at risk for PTSD include chronically ill psychiatric patient and childhood abused and neglected populations, click for more

    Are stimulants addictive in children? What the evidence says. : Despite the increasing use of stimulants in younger and younger children, few studies have examined this important issue, not enough to conclude whether stimulants are not addictive. click for more

    Opposite effects of high and low frequency rTMS in depressed patients. : As with neurofeedback, the effects of rTMS are frequency-dependent. In fact opposite effects were found for high and low frequency rTMS on local and distant regional brain activity. click for more

    The severity of alcohol withdrawal is not age dependent. : Severity of alcohol withdrawal syndrome did not differ between age groups. click for more

    Use and costs of medical care for children and adolescents with and without ADHD : Individuals with ADHD are more likely to experience major injuries (59% vs 49%), asthma (22% vs 13%), and other diagnoses; in fact overall medical costs for ADHD individuals doubles non-ADHD individuals ($4306 vs $1944). click for more

    Needs and costs of sleep monitoring. : Insomnia affects approximately 1 in 6 adults and sleep apnea syndromes 1 in 15, yet assessment is currently too costly for many. The authors suggest ambulatory monitoring of sleep disorders to decrease cost and long waiting lists. click for more

    Suicidal ideation in major depression: sex differences and anxiety. : More women than men with major depression experienced suicidal ideation, but both men and women with a lifetime anxiety disorder are more likely to be suicidal. click for more

    Benefit-cost analysis of residential and outpatient addiction treatment : Residential care is favored over outpatient care from an economic perspective, though both are beneficial. Residential treatment costs approx. $2,530, outpatient care $1,138; net benefits were estimated to be $17,833 and $11,173, respectively. click for more

    Depression in adolescents growing pains or true morbidity? : Depression in childhood contiues into adulthood more than half the time. Childhood depression often results in bipolar disorder within 5 years. click for more

    Sleep quality and quality of life for individuals with chronic pain conditions. : Physical functioning, duration of pain, and age are often more important than pain intensity and depressed mood in reducing sleep quality. click for more

    The neuroscience of depression in adolescence. : As with adults, endocrine studies indicate a dysregulation of the serotonin (5-HT) axis in childhood depression. Neuroimaging techniques implicate the frontal lobes in the pathogenesis of depression. click for more

    What's all the fuss about Ritalin? : ADHD is sometimes overdiagnosed but is possibly more often underdiagnosed. Pediatricians should play a proactive role in the screening, diagnosis, and treatment of ADHD. click for more


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